Medical Case Reports

A major new study has shed light on one of the most puzzling vaccine-related complications identified during the COVID-19 pandemic: vaccine-induced immune thrombotic thrombocytopenia (VITT). This rare condition, linked primarily to adenovirus-based COVID-19 vaccines such as Johnson & Johnson and AstraZeneca, involves unusual blood clotting combined with low platelet counts. For years, scientists have debated what triggered VITT and why it appeared in only a tiny fraction of people. New research now provides the clearest explanation yet — and suggests that both immune biology and genetics play a role. When VITT cases first emerged in 2021, researchers noticed that affected patients developed antibodies against platelet factor 4 (PF4), a molecule involved in blood clotting. What remained unclear was why the immune system would suddenly target PF4 after vaccination. The new study points strongly to the adenovirus vector itself as the initial trigger. Researchers found that in peopl...

 A 39-year-old veteran, with a history of tension-type headaches, noticed a burning odor sensation approximately three weeks after receiving the J&J COVID-19 vaccine, about four months prior to his visit to the neurology clinic. Concerned about this peculiar symptom, he underwent a nasal swab antigen COVID-19 test, which returned negative. Initially, the episodes occurred daily, lasting about one hour each time. However, as time passed, they became less frequent, shorter in duration, and less intense. About 11 months post-vaccination, milder episodes occurred only 1 to 2 times weekly. These olfactory hallucinations persisted for nearly two years (21 months post-vaccination), occurring randomly throughout the day and unrelated to any other symptoms.  When the veteran presented to the clinic, both general and neurological examinations yielded unremarkable results. Brain magnetic resonance imaging (MRI) did reveal chronic sinusitis but showed no other abnormalities. It's imp...

A 78-year-old healthy woman was presented with blurry vision in her left eye 1 day after receiving the third dose of the Pfizer-BioNTech COVID-19 vaccine. The ocular examination revealed an optic disc swelling and retinal thickening of the macula with subretinal fluid in the left eye. The fluorescein angiography revealed hyperfluorescence of the left optic disc. The neuroretinitis resolved gradually after taking azithromycin and prednisolone orally. unilateral neuroretinitis A 30-year-old female was diagnosed with bilateral acute anterior uveitis about a month after Pfizer COVID-19 booster vaccine and was started on prednisolone and cyclopentolate in both eyes. The symptoms had initially improved after a week of therapy, but a couple of weeks later she noticed that the visual acuity in the right eye precipitously dropped, which she described as “smoke” in her vision. She progressed to a serous retinal detachment involving the fovea in the left eye. Unilateral neuroretinitis is often ...

A 37-year-old South Asian woman  with a 7-year history of rheumatoid arthritis (on bi-weekly tocilizumab injections) tested SARS-CoV-2 positive 9 month after receiving her vaccination (JNJ-78436735). She experienced persistent headache and fatigue for >6 weeks after infection and continued to test intermittently antigen+ for 14 weeks post-infection despite no overt exposure to SARS-CoV-2 infected individuals. She lived alone, did not leave her residence without a surgical-grade N95 mask, and never removed the mask in public. She was subsequently prescribed a 5-day course of nirmeltravir/ritonavir 300/100 mg twice daily. Initially, all PASC symptoms resolved, and the patient tested antigen negative 3 weeks after completion of nirmeltravir/ritonavir, but the symptoms and antigen positivity subsequently reappeared at 4 weeks (see figure). Assessment of adaptive immune responses demonstrated that nirmatrelvir/ritonavir and tocilizumab treatment decreased antiviral and autoreactive T...

We observed cases of transient global amnesia (TGA) after the 1st or 3rd dose of a COVID-19 vaccine in the elderly population of our study .   Recent review of  reports from the World Health Organization VigiBase ®  ideitified 289 TGA cases associated with a COVID-19 vaccine.  The  Pfizer-BioNTech COVID-19 Vaccine, also known as COMIRNATY® or  Tozinameran was mostly represented (147, 50.8%), followed by t he Oxford/AstraZeneca or ChAdOx1-S AZD1222 (69, 23,8%), Moderna -  SPIKEVAX,  elasomeran - (60, 20.8%), and JNJ-78436735 (12, 4.2%).  Cerebrovascular, inflammatory, or migrainous mechanisms may underlie this association. Yet, numerous confounding factors cannot be tackled with this approach, and causality cannot be ascertained.  Here is an exemplar medical case : Two weeks after receiving the first dose of ChAdOx1 nCov-19 vaccine, a disease-free 38-year-old woman experienced acute onset of abnormal symptoms, such as amnesia, incoh...

In the period 27 December 2020 to 15 February 2021, about 29 400 of Norway's nursing home patients (aged  61–103)  were vaccinated with the mRNA vaccine BNT162b2. During the same period, the Norwegian Medicines Agency received 100 reports of suspected fatal adverse reactions to the vaccine. An expert group has examined the 100 reported deaths and concluded that 10 (10 %) are most likely related to the vaccine while there could be a possible link for other 26 individuals (26 %).  A  recent review  of other 38  cases linking the COVID-19 vaccines and the death found the following causes of death: vaccine-induced immune thrombotic thrombocytopenia (VITT) (32), myocarditis (3), acute disseminated encephalomyelitis (ADEM) (1), myocardial infarction (1), and rhabdomyolysis (1) . More than half of these cases were in elderly individuals. Unfortunately,  there were only a few publications on postmortem diagnostics of adverse events link...